Faith-Based Organisations
and
HIV/AIDS Prevention and Impact Mitigation in Africa
A Desk Review by
Georges Tiendrebeogo and Michael Buykx
Amsterdam, 30 March 2004
Box 1 disclaimer.
This draft text was submitted to the Royal tropical institute (KIT) in Amsterdam as contribution to Chapter 5 of the report "Faith-based Organisations and HIV/AIDS prevention and impact mitigation in Africa" by Georges Tiendrebeogo and Michael Buykx. The substantially changed version is available online at www.kit.nl. (Acrobat reader format). Please quote only from the KIT website, indicating the official source. |
5. Christian Perspectives
The role of Christian FBOs in preventing the spread of HIV/AIDS (section 5.2) has predominantly been characterised by the deadlock over condom use. Christian organisations for the most part do not promote condom use, and non-Christian stakeholders have questioned the efficacy of the church's emphasis on abstinence and fidelity. In contrast, care and support seems to be dealt with effectively by Christian networks of volunteers, hospitals and health centres. It will be discussed in section 5.3.
5.1 Christian churches in Africa
Sub-Saharan Africa is the most Christian of all continents after Latin America. Roman Catholic and many Protestant Churches were founded there in the era of colonialism and missionary work. While these missions have served some colonial purposes, they have also provided the local community with a church, a school and health facilities.
Recently founded independent African churches, and some theological movements within the older churches, are engaged in a process known as "inculturation". [1]
Put simply, Africans are adapting Christian theology to their own context, synthesising Christian teachings with African values and culture. In the process, they are finding new forms for aspects of liturgy, art and theological tradition considered Western or colonial. The justification for "inculturation" is that even before the Gospel as preached by Jesus Christ in Israel 2000 years ago arrived in Africa, it had been adapted to the Greek civilization of Europe by the Apostles. [2] Similarly, in the fight against HIV/AIDS, religious and political leaders link Christian teaching to their own African culture and tradition. The Bishops of Cameroon write: "The Church calls on men and women of good will to put all hands on deck to wage an all-out war against this pandemic, by taking part in public sensitisation, information and education activities, without hesitating to fall back on our cultural and spiritual values." [3]Consequently, people can no longer simply blame religious leaders outside Africa for unpopular messages. Since the Second Vatican Council, regional conferences of bishops have taken an important initiative and a certain amount of liberty in teaching the doctrine of the Catholic Church. To reconcile the Christian view on marriage with the African cultural context might constitute one of the m
ost difficult issues: "As a matter of fact, nothing in Africa has more resisted Western Christianisation than marriage." [4]
Box
2: "Jesus' response to stigmatization." Whatever the reasons for stigmatization of people living with HIV/AIDS that may have occurred in Christian communities, the attitude of Jesus Christ seems to have been quite different: When the Jews
brought a woman who had been caught committing
adultery, and asked for his opinion whether she should be stoned, he only
said: "Let the one among you who is
without sin be the first to throw a stone at her." When all had left, one
by one, he told the woman: "Neither do I condemn you. Go, and from now on
do not sin any more." (John 8,3-11) This illustration was used as a frontispiece
of the Acts of the Ecumenical Pastoral Congress on HIV/AIDS in Benguela,
Angola. In the process of "inculturation" this Biblical scene is transposed
to the African cultural context (here: of the Mafa tribe in
Cameroon). |
5.2 Christian churches’ perspectives on HIV/AIDS prevention
5.2.1 Ethical and moral teaching
Christianity is defined as a religion of love: Divine love for humankind, reflected in mutual love of human beings. This love may be celebrated in the gift of sexual intimacy by a couple. But whereas modern attitudes towards sexual pleasure tend to detach it from procreation and a lasting mutual commitment, the churches emphasise the importance of marriage in which responsibility, faithfulness, and exclusive intimacy are considered essential.[5] All Christian denominations see the exclusiveness of sexual intimacy as an essential value of the Gospel.
Many church denominations ban the use of condoms. The Catholic Church took a strong position against condom use in 1965 when Pope Paul VI spoke out on family planning issues. The encyclical Humanae Vitae[6] said that sexual contacts, reserved for married couples, should not be barred from transmitting life by condoms. The emotional upheaval over Humanae Vitae continues to resonate in the era of AIDS. However, in relation to AIDS, the condom issue is quite different. The churches - Catholic and Protestant alike - are aware that sex before or outside marriage is common practice but consider it contrary to their doctrine and interpretation of the Gospel. Use of a condom is perceived as a moral issue directly related to the view of the Churches on marriage and sexuality.
The churches will not change their position on condom use completely, although there is some recognition that sexual contacts may transmit a deadly virus rather than life. In this case, the commandment: "Thou shall not kill"
prevails, especially in the situation of a discordant couple.The churches also claim to be misunderstood in some aspects. They say that they are not so much objecting to the use of a condom in any situation as to its wholesale propaganda and promotion. [7] They ar
e especially opposed to the more extreme slogans. For example, the slogan "No limits on sex, provided it is safe" carries a "two-in-one"message. It is the first part that provokes indignation of the churches. Their view is that sexual love requires a couple to accept all the responsibilities of marriage, including the responsibility not to transmit death. The Vatican Council for the Family uses technical as well as moral arguments against condoms. [8] However, Bénézet Bujo, a prominent Congolese moral theologian from the inculturation movement was invited to explain his view at the Conference dedicated to HIV/AIDS of all Catholic Bishop Conferences in Africa and published online at the SECAM website. [9]The outspoken position regarding condoms by the Catholic Church and most Protestant churches complicates HIV/AIDS prevention campaigns aimed at reducing unsafe sexual practices. However, this doctrine does not necessarily render churches unfit to promote HIV/AIDS prevention.
Christian FBOs have highlighted the importance of targeting women in preventing the spread of the disease. Many women and girls are forced to accept sexual contacts due to poverty or gender inequality. At the XIIIth General Assembly of SECAM in Dakar, October 2003, the Symposium of Episcopal Conferences of Africa and Madagascar HIV/AIDS was one of the major topics. [10] A plan of action was accepted focussing on gender issues in order to protect girls, young people and women from their vulnerability to HIV infection.
Box
3: The fleet of hope A prevention campaign which is compatible with the general UNAIDS strategy, is the so-called "Fleet of Hope". It was developed in Tanzania by Bernard Joinet, a lecturer in clinical psychology at Dar-es-Salaam University, where he served as well as a Roman Catholic Chaplain for many years. He saw in distress how the epidemic spread dramatically whereas various stakeholders sent conflicting messages of prevention. He then elaborated a campaign based on visual images, inspired by Noah's Ark. There are two basic assumptions: People
are more sensitive to emotional imagery and pictures than to theory and
factual text. The responsibility of a national government is different from the responsibility of the various groups in society.
The message consists of 4 sections, in all 44 posters:
1. AIDS is like a Flood (1-18)
2. Different responsibilities (19-24)
3. Individual options (25-36)
Experiences
The association "La Flottille de l'Espoir" [11]in France facilitates worldwide
distribution of the 44 posters, a pedagogic handbook, and the discussion game.
|
The Church and secular services do not operate in isolation. As the Fleet of Hope example shows, FBOs do find ways to stimulate safe sex practices. Similarly, most secular HIV/AIDS prevention campaigns no longer limit their message to promoting condoms. The other two main prevention strategies - abstinence, and fidelity to one un-infected partner -are neither easy nor popular. But the Churches have a comparative advantage in preaching them. Given the social context and value system of the Churches, these strategies can be promoted with credibility.
A growing trend exists in some Churches to allow the use of condoms as the lesser evil", if sexual contact will put the other partner at risk of mortal danger.
[13]
"There are couples where one of the parties is living with HIV/AIDS. In these cases there is the real danger that the healthy partner may contract this killer disease. The Church accepts that everyone has the right to defend one's life against mortal danger. This would include using the appropriate means and course of action."
[14]
The practice is not entirely unchallenged within the Church as some fear that allowing exceptions may be used to promote family planning.
[15]
Abbé Alexandre Mbengue, the director of a major priest seminary in Senegal, is quite clear on this matter. He says that the "Loi de la Gradualité" has to be applied if abstinence is not an option for two married people: using a condom is preferred to transgressing the commandment: "Thou shall not kill"
[16]
Bishop Kevin Dowling from the heavily HIV-infected mining district of the Rustenburg Diocese in South Afri
ca, is the initiator of the AIDS Office of the Southern African Catholic Bishops' Conference. He goes even further: "We live in a world where many people choose not to live according to the values espoused by the church. And especially in our southern African region, there are so many poor people, women and girl children whose socio-economic and cultural situation takes away their options and choices. In those situations, I believe that people living with HIV must be invited and challenged to use a condom in order to prevent the transmission of potential death to another person, or to protect themselves from infection, especially in abusive and destructive relationships." [18]
Box 4 Pastoral congress on HIV/AIDS in
Benguela Diocese, Angola
|
|
---|---|
The Fleet of Hope prevention campaign (see
Box 3) being presented
at the first pastoral congress on HIV/AIDS in Benguela Diocese,
Angola. Proceedings: www.aids-church.tk |
The churches also play an important role in education, managing schools, and organising training sessions. The final resolution of
the second "Colloquium on AIDS and Religion" in Senegal states: "It is necessary to intensify the effort in literacy in order to promulgate information on HIV/AIDS. It is necessary to intensify collaboration between the various social structures of the Church: Health, Education, Caritas, Women empowerment." [19]In other instances, Christian
values can have a negative impact on AIDS prevention in schools. An Action AIDS report on schools in Kenya states: "Teachers exercise a self-imposed veto on sections of the curriculum that deal with any practices they feel will offend local beliefs. In Kenya particularly, Catholicism has a big effect on the way HIV is taught and teachers view this as having a negative impact". [21]This apprehension over causing offence leads teachers to skip HIV altogether, or to address it in a technical way, leaving out issues of sexuality, human values and stigma. The Plan of action of SECAM the PAN-African synod of Catholic bishops regarding HIV/AIDS may help them to overcome that fear.
[22]
5. 3 Christian churches' perspectives on HIV/AIDS impact mitigation
5.3.1 Christian churches and HIV/AIDS medical and social care and support
A strong current of helping others runs through Christian doctrine, from Jesus Christ's unconditional love for lepers
[23]
Even when the moral issues created by the prevention campaigns initially led some church leaders to remain silent on the AIDS pandemic - or even to oppose action undertaken by others - the response of their medical staff to the explosion of patients was more than adequate.The Catholic Church claims to deliver 19% of all health service and 25% of all social service related to HIV/AIDS.
[24]
Home-based care has emerged as an important aspect of Christian care for PLWHA. The move was necessitated by the magnitude of the crisis, in which hospitals were running out of space. The inner cohesion of a congregation or parish combined with medical know-how, trained staff and external networks is a strong asset of the churches. Volunteers for Christian FBO home-based care tend to be more motiv
ated than their secular colleagues. This may be due to the shared value system of the caregivers. Liebowitz coined the theory of "the social capital of FB0s". He argues that since in many religious institutions members regularly engage themselves in activities that build trust and community, the members are more likely to use these religious institutions to accomplish social goals. [25]
Box
5: Ndola home based care
An important stigma fighter is Gideon Byamugisha of the
Anglican Church of Uganda. He addressed the ecumenical advocacy alliance
HIV/AIDS strategy group on the launch of the campaign on HIV/AIDS world AIDS
day 01-12-2001: "My own church continues to take up its part in this
campaign by challenging the stigma that is usually attached to HIV/AIDS. In a
few days I will be made a Canon of the Anglican Church. You may ask,
"What does this have to do with HIV/AIDS and stigma?" The answer is
simple yet painful…you see I am living with HIV. (...) I can testify that my
church cares. She did not throw me out when I disclosed that I was HIV
positive way back in 1992. Instead, she supported me in the task of
developing an HIV prevention and AIDS care program that integrates issues of
sex, sexuality, and sexuality in worship; in Christian literature and in
ministry with children, young people and parents. As church, we have worked
together (albeit in a small way) in: I) extending subsidized HIV counseling
and testing services to those wishing to know their HIV status; ii)
initiating post-test HIV support clubs for continuous counseling, social and
spiritual support to those living with HIV/AIDS; iii) training and
commissioning "Good Samaritan" home care teams among children,
youths, and adults in the church; and iv) starting health units where there
are none and strengthening those that lack medicines and equipment."[41] Canon Byamugisha
subsequently developed AIDS liturgy to span the church liturgical year
and keep HIV/AIDS and those infected and/or affected by it in the liturgical
prayers of the church. And he mobilized church leaders "Christian church
leaders need to be met where they already have strengths, in using the Bible,
before training about research and statistics"[42]
[1]
Baur, John, 2000 years of
Christianity in Africa (Nairobi 1994); the African Bible (Nairobi 1999). [2] Pondy, P. (Direction
Catholic Schools Yaoundé) "Why an African Christ?" http://www.jesusmafa.com/anglais/noir.htm [3] NECC (1999), Cameroon bishop's
declaration on AIDS, Yaoundé, 8 December 1999, p.9 [4] Baur (1994) 469. [6] http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html [7] Southern
African Catholic Bishop's Conference, "A Message of Hope", July 30th, 2001 http://www.sacbc.org.za/aisdpubhope.htm [9] Bénézet Bujo, "Quelle
morale pour le problème du SIDA en Afrique?" http://www.sceam-dakar.sn/moralesidaafrique.htm [10] The church in Africa in face of The HIV/AIDS pandemic: "our prayer is
always full of hope" Message issued by the Symposium of Episcopal
Conferences of Africa and Madagascar, Dakar 2003http://www.jesuitaids.net/secam-aids2003e.htm;
http://www.sceam-dakar.sn/resolutionsfinales.htm [11] Association Flottille de l'espoir, 103, av de
Villiers, 75017 Paris – France. www.fleetofhope.tk http://www.vihinternet.org/afrique/savoir/flotille.htm
(French version) http://www.kit.nl/information_services/exchange_content/html/1996_2_fleet_of_hope.asp
(English description) www.sida-igreja.tk
(Portuguese web version) [13] Suaudeau, Mgr. Jacques (2000),
"Prophylactics or Family Values? Stopping the Spread of HIV/AIDS", L'Osservatore
Romano, 19 April 2000; http://www.ccli.org/reviews/Suaudeau.shtml#Article; [14] Southern African Bishops' Conference "Message of
Hope" 30 Jul 2001. http://www.sacbc.org.za/aisdpubhope.htm [15] www.condoms4life.org; Jon D. Fuller and James F. Keenan
"Tolerant Signals: [16] Mbengue, A. (1996), "Ethique Chrétienne et
SIDA: Promouvoir la Vie" in SIDA Service, National AIDS Programme; USAID (1996), Actes du Deuxième Colloque National
SIDA et Religion, Réponses de églises Chrétiennes, SIDA Service Report, Dakar,
9-10 January 1996, p.52 [17] SIDA Service, National AIDS Programme, and
USAID (1996), 'Déclaration de la conférence des Evêques du Sénégal,' Dakar, 10 January 1996; Actes
du Deuxième colloque national SIDA et Religion, Réponses de églises Chrétiennes, SIDA Service Report,
Dakar 9-10 January 1996, p.104 [18] Byamugisha, Gideon and Steinitz, Lucy et al.
(2002), "Joumeys of Faith" (TALC St Albans), p.94 [19] SIDA Service (1996), Resolution Finale,
Actes du Deuxieme colloque national SIDA et Religion, Réponses de églises
Chrétiennes , SIDA Service Report, Dakar, 9- 10 January 1996, p. 12 [20] Sumbelelo, Father Emilio (2002), "'A
prevenção do HIV-SIDA nos pronunciamentos da igreja", Benguela, Angola; http://huizen.dds.nl/~mh2/ port/sida/sumbelelosida.htm [21] Boler jania (2002), "The sound of silence
- difficulties on communicating on HIV/AIDS in schools", Action AID, London http://www.actionaid.org/resources/pdfs/soundofsilence.pdf [22] The church in Africa in face of The HIV/AIDS pandemic: "our
prayer is always full of hope" Message issued
by the Symposium of Episcopal Conferences of Africa and Madagascar, Dakar 2003 http://www.jesuitaids.net/secam-aids2003e.htm; http://www.sceam-dakar.sn/resolutionsfinales.htm [23] Fr. Ezequiel Faria, "Cristo não veio
explicar o mistério do sofrimento, mas veio sofrer connosco", Benguela, 7 December 2001, http://www.sida-igreja.tk [24] Message of Card. Javier Lozano Barragán
for the World Day of AIDS (November 30, 2003) http://www.vatican.va/roman_curia/pontifical_councils/hlthwork/documents/rc_pc_hlthwork_doc_20031130_barragan-aids_it.html; [25] Jeremy Liebowitz, "The impact of
faith-based organizations on HIV/AIDS prevention and mitigation in Africa",
(Natal, 2002) http://www.und.ac.za/und/heard/publications/FBOs%20paper_Dec02.pdf
p. 17 [26] http://www.bathwells.anglican.org/mission/wm_lect04_1.pdf Blinkhoff, Petri, Bukanga, Esaya
et al., (1999) "Under the Mupundu Tree Volunteers in Home care for people with
HIV/AIDS and TB in Zambia's Copperbelt", Action AID, London http://www.thebody.com/unaids/wac2002/countering_stigma.html#8 http://www.unaids.org/bestpractice/digest/files/Volunteersinhomecare.html http://europa.eu.int/comm/development/publicat/courier/courier189/en/en_002_ni.pdf [27] Byamugisha and Steinitz et al. (2002) p.24 [28] Kelly, M. J., "What AIDS does to
Education" http://www.jesuitaids.net/whataiddoes.htm [29] Haendler, R. (2001), "Pastoral roles in
HIV and AIDS prevention and Care" in UNAIDS Round Table on "Faith-based
strategies, achievements and challenges in their response to the HIV/AIDS
Pandemic", p.5; International Confèrence on STDs and AIDS, Burkina Faso, 12
December 2001 [30] "Increased Partnership between Faith-Based
Organisations, Govemments and Inter-Govenunental Organisations", Statement by Faith-Based Organisations
facilitated by the World Council of Churches for the UN Special General
Assembly on HIV/AIDS, 25 - 27 June 2001 http://www.wcc-coe.org/wcc/what/mission/ny-statement.html [31] Vitillo, Robert (1994), "Theological
challenges posed by the global pandemic of HIV/AIDS", Boston http://www.natcath.com/NCR_Online/documents/VitilloHIVreport.htm [32] Ibid. Liebowitz (2002), p. 20 [33] Ibid. Vitillo, Robert (1994) [37] Campbell, Ian D., HIV/AIDS, Stigma and
Religious Responses, An overview of issues relating to stigma and the religious
sector in Africa http://www.ccih.org/compendium/HIV-AIDS,%20STIGMA%20AND%20RELIGIOUS%20RESPONSES.html;
Delle, Edmund N., Fellowship of
Christian Councils and Churches in West Africa at UNAIDS Round Table, December
2001, "Combating and dismantling STIGMA – what is working and what has not
worked" [39] Ibid. Haendler, R. (2001) 41 http://www.ccih.org/aids-resources.html;
http://www.biblenetworknews.com/africa/112802_uganda.jpg http://www.worldvision.org/worldvision/comms.nsf/stable/reverend_gideon http://www.un.org/works/worldaidsday/gideon.html http://www.anglicancommunion.org/acns/articles/32/00/acns3218.html [42] Byamugisha,
Gideon "Mobilizing and Equipping Church Leaders in Uganda" http://ccih.org/forum/0110-08.htm |